Are 'smart drugs' safe for students?


Students are increasingly taking neuroenhancing drugs to fight fatigue and help them concentrate. But how safe are they – and is it cheating?

It is an all too common story: a diligent student works hard and finally achieves a coveted place at Cambridge University. Once there, the pressure becomes too great and they turn to drugs. These days, however, the old narrative has changed. Instead of the spliffs that apparently so delighted generations of our politicians, the latest fad is for educational, not recreational, drugs.

"It was the summer term of my second year," explains Raj Perera, in his final year of a natural sciences degree at Cambridge University. "I'm an international student, which means my parents are paying £20,000 for every year I am here. That sort of money puts a huge pressure on you. But last summer, I had two weeks to go before my exams, and I had done pretty much no revision. It was a make-or-break moment. So I bought modafinil."

Modafinil is one of the new neuroenhancing "smart drugs" now being taken by growing numbers of students. It was originally developed for the treatment of narcolepsy, but is now used by students to combat fatigue. Another popular choice is Ritalin, originally designed as a treatment for attention deficit hyperactivity disorder (ADHD). Both increase levels of dopamine levels in the brain – and the alertness and wakefulness of those taking them.

So popular have these drugs become that last month Barbara Sahakian, professor of clinical neuropsychology at Cambridge University's psychiatry department, warned that their use has "enormous implications" and that universities must act on them – even mentioning dope testing as one possibility. But this is not happening. "What universities are doing about [them] is nothing," she says.

Last year, Sahakian was co-opted on to a committee, set up by the Medical Advisory Council on the Misuse of Drugs, to look at the use of cognitive enhancing drugs by healthy people. One American study, cited in the journal Nature, estimated that up to 25% of students at some campuses had taken neuroenhancing drugs in the past year.

Many hear of these drugs through friends, others independently. "I read an article in the student press on them," says Lawrence Price, a third-year arts student at Sheffield Hallam University. "It was criticising them, but I thought they sounded great." Perera, similarly, found out about smart drugs through the media. "I read an article in Nature on them," he says. "They seemed a pretty good idea."

Students believe the drugs enable them to do more work. "I take them when I need to get through lectures and I have a terrible hangover," says Price.

At the other extreme, Lucy Makepeace, a postgraduate student at Cambridge, uses them less from a lack of diligence than an excess of it. Extremely hard working, she takes modafinil once or twice a week. "With study, work and sport I have a very full timetable," she says. "I want to do everything, but I don't want to do any of it at a mediocre level. Taking modafinil helps me to do it all."

Perera similarly turned to modafinil from time pressures – which were, in his case, extreme. "Due to difficulty getting my visa last year, I couldn't return at the start of the summer term," he says. "When I eventually got my visa, I arrived back with just a fortnight before my exams, and no revision behind me."

All the students are clear on the drug's effects. "Modafinil increases my enthusiasm for studying," says Perera. "It makes me feel that lazing around is the last thing I want to do." Price agrees: "Modafinil gives me the motivation I would otherwise lack." Makepeace, who clearly doesn't lack motivation, instead takes modafinil to stay alert. "Once I've taken a pill I can stay up all night without stopping. It just works so well," she says. "I need it."

The way the students obtain the drugs varies. Some get them from friends, but many purchase them from online chemists. "I just Googled them," says Perera. "The cost, including shipping, came to about £2 each." "I bought them from an online pharmacy," says Price. "You just sign a disclaimer saying you won't sue them for selling you prescription drugs without a prescription, then they send you them."

Such a convenient process might please the consumer, but it is not one that impresses Sahakian. "When you get a drug off the internet, you don't know what it is, or whether you have some pre-existing condition that means you shouldn't be taking it," she says. "If you get a drug from your GP, they would check that."

Even if the drugs are what they purport to be, they are not risk-free. Such smart drugs have only been developed relatively recently, and, says Sahakian (who has herself researched the effects of modafinil on healthy volunteers), it is therefore too early to feel confident that they are safe. "It's a real worry that students are taking these drugs, as we just don't know whether they are safe in the long term. They're so new. How could we know?"

In addition to concerns about the drugs' physical effects, there are also moral issues. "Do we want to solve all our problems in this way?" Sahakian asks. "There are other ways of coping – like exercise, or sleep." Such methods would not only be physiologically better, but also psychologically. "It's nice to feel that what you have achieved is your achievement. Take a pill and you might not feel that," she says.

For some, chemically enhanced achievement is reprehensible. "Students who are not taking them, feel [to do so] is cheating," says Sahakian. "They feel that [taking these] could just make the difference between a 2.1 and a first. At that point, students who don't want to take them start to feel coerced into doing so because everyone else is." But the accusation of bending the rules is denied unanimously. "I'm not cheating," says Makepeace. "Taking a pill is no different to having a cup of coffee. It's just more effective." Perera agrees: "I don't think this is cheating. I read a nice analogy, which said that people with a bad memory are no different to people who have bad eyesight. You let people with bad eyesight have glasses; why not let people with a bad memory have these pills?"

At present, the actual status of such drug-taking remains undefined by universities, something that Sahakian hopes they will soon address. "Universities need to think about whether they want their students to be on drugs or not when they come into their exams. There needs to be some debate within the universities. Do we care about this? Is this cheating? Is it the way we want our society to be going?"

Professor John Rallison, pro vice-chancellor for education at Cambridge University, said the university "does not approve of any non-medicinal drug-taking", and welfare officers at the university's union said that they were concerned about such usage.

The view is echoed by Universities UK, the body representing the heads of British universities, which says it has "grave concerns about students taking drugs not prescribed to them", because it "poses health risks to those students". Instead, it advises pressurised students to seek help from university counselling services or the GP.

A spokesman for Sheffield Hallam University said: "We are not aware of any student taking this drug and if any students do have difficulties with their studies we encourage them to make use of our support services."

Given the habits of academics themselves, the topic is a sensitive one: according to a recent survey by Nature, whose readership tends to be academics and researchers, one in five respondents said that they had used smart drugs.

Something of which Sahakian herself has personal experience. "I was at a conference in America recently," she says. "I'd just flown in that day from the UK. I saw I was timetabled to give a lecture that afternoon. I wanted to do a good job of it, but I was just feeling so jetlagged. I mentioned to a colleague how I felt and he immediately said to me, 'Oh, do you want to take some of my modafinil?'"

She didn't, for the record, accept.

• All student names have been changed

alert : czujny

alertness : czujność

coerce into : zmuszać do

cognitive : poznawczy, kognitywny

combat : pokonać

convenient : dogodny

co-opt : kooptować

coveted : wymarzony, upragniony

diligence : pilność, sumienność, pracowitość

diligent : pilny, pracowity

disclaimer : oświadczenie o zrzeczeniu się

dopamine : dopamina

dope : narkotyk

enhanced : stymulowany

enhancing : stymulujący

fad : moda

GP : internista

implication : implikacja, konsekwencje

mediocre : lichy, mierny

misuse : zły użytek, niewłaściwe stosowanie

narcolepsy : narkolepsja

neuroenhancing drugs : leki o działaniu stymulującym na ośrodkowy układ nerwowy

pose : stanowić (problem)

purport to be : wydawać się być

reprehensible : naganny

spliff : skręt z marihuany

sue : pozwać

unanimously : jednogłośnie

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